Noninteraction of the heart and kidney

Also:

• Heart and kidney failing to interact (心肾不交 xīn shèn bù jiāo), an alternative translation of same Chinese term
• Heart-kidney yīn vacuity and yáng hyperactivity (心肾阴虚阳亢 xīn shèn yīn xū yáng kàng)
• Fire and water failing to help each other (水火不济 shuǐ huǒ bù jì)

A disease pattern chiefly characterized by heart vexation; insomnia; profuse dreaming; dream emission; tinnitus; limp aching lumbus and knees; yīn vacuity signs.

Description: Heart vexation; heart palpitation; insomnia and profuse dreaming; forgetfulness; dizzy head; tinnitus; limp aching lumbus and knees; dry mouth and pharynx; vexing heat in the five hearts; tidal heat effusion; night sweating; seminal emission (dream emission); bound stool and yellow urine; red tongue with little fur; and a pulse that is find and rapid.

Diseases: Heart palpitation; fearful throbbing; insomnia; forgetfulness; and seminal emission.

Pathogenesis: Insufficiency of the yīn humor of the heart and kidney that causes yáng qì to become hyperactive.

Heart yīn and heart yáng are mutually counterbalancing, as are kidney yīn and yáng. Furthermore, heart yáng and kidney yīn counterbalance each other to some degree. This is described as heart fire and kidney water interacting or heart fire and kidney water helping each other. Kidney-water prevents heart-fire from becoming hyperactive, while heart-fire prevents kidney-water from becoming cold. If kidney-water is insufficient and fails to help the heart, or if heart fire stirs and scorches kidney yīn, the result is noninteraction of the heart and kidney, a pattern of kidney yīn humor depletion and yáng qì hyperactivity.

• Yīn failing to restrain yáng: This occurs when damage to kidney yīn attributable to sexual intemperance, vacuity taxation, or enduring illness deprives heart yīn of nourishment, causing hyperactivity of heart yáng, which then harasses the heart spirit.
• Hyperactive yáng damaging yīn: This occurs when excessive thought or preoccupation causes wear on heart yīn that leaves heart yáng unrestrained or when affect-mind frustration and depression cause qì to become depressed and transform into fire, which then affects the heart.

In either of these cases, the result is hyperactivity of heart yáng, which in turn damages kidney yīn.

Heart yáng is often referred to as the sovereign fire. The sovereign fire stands in contrast to the ministerial fire, which is the fire said to inhabit the life gate, the liver, gallbladder, and triple burner. Noninteraction of the heart and kidney manifests not only as hyperactivity of the sovereign fire but also as frenetic stirring of the ministerial fire (liver-kidney yīn vacuity with vacuity fire flaming upward), which can result in excessive libido, frequent and persistent erections, and seminal emission (dream emission).

Modern clinical literature mostly defines noninteraction of the heart and kidney exclusively as yīn vacuity and yáng hyperactivity. Some sources, however, also include upper body heat and lower body cold as an alternative form. This arises when heart yáng is exuberant in the upper body but fails to warm kidney yáng. This is often described as fire failing to home to its origin.

Analysis of signs

• Kidney yīn vacuity: Limp aching lumbus and knees, dizzy head, and tinnitus.
• Vacuity heat: Vexing heat in the five hearts; tidal heat effusion; night sweating; dry mouth and pharynx.
• Hyperactive heart yáng: Heart vexation and palpitation; insomnia; profuse dreaming; forgetfulness; and in some cases, mouth and tongue sores.
• Frenetic stirring of the ministerial fire: Excessive libido, frequent and persistent erections, seminal emission (dream emission).
• Tongue: Red.
• Pulse: Fine and rapid, reflecting yīn vacuity and heat respectively.

Treatment

Medicinal therapy: Promote heart-kidney interaction. Use Coptis, Ass Hide Glue, and Egg Yolk Decoction (黄连阿胶鸡子黄汤 huáng lián ē jiāo jī zǐ huáng tāng) or Peaceful Interaction Pill (交泰丸 jiāo tài wán). For pronounced yīn vacuity, use liù wèi dì huáng wán (六味地黄丸 Six-Ingredient Rehmannia Pill). For heart palpitation, use tiān wáng bǔ xīn dān (天王补心丹 Celestial Emperor Heart-Supplementing Elixir).

Acumoxatherapy: Base treatment mainly on back transport points, HT, and KI. Select BL-15 (Heart Transport, 心俞 xīn shù), BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), KI-1 (Gushing Spring, 湧泉 yǒng quán), HT-7 (Spirit Gate, 神门 shén mén), PC-8 (Palace of Toil, 劳宫 láo gōng), PC-7 (Great Mound, 大陵 dà líng), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with even supplementation and drainage, or supplement the kidney and drain the heart.

Point selection according to signs: For insomnia, add Alert Spirit Quartet (四神聪 sì shén cōng). For profuse dreaming, add GB-44 (Foot Orifice Yīn, 足窍阴 zú qiào yīn) and ST-45 (Severe Mouth, 厉兑 lì duì). For heart palpitation, add PC-6 (Inner Pass, 内关 nèi guān). For seminal emission, add PC-7 (Great Mound, 大陵 dà líng). See promoting heart-kidney interaction.